Cannabis and cannabinoids in adults with cancer: ASCO Guideline

Authors

Ilana M. Braun, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Kari Bohlke, American Society of Clinical Oncology, Alexandria, VA.
Donald I. Abrams, University of California San Francisco Osher Center for Integrative Health, San Francisco, CA.
Holly Anderson, Breast Cancer Coalition of Rochester, Rochester, NY.
Lynda G. Balneaves, University of Manitoba, Winnipeg, MB, Canada.
Gil Bar-Sela, Emek Medical Center, Afula, Israel.
Daniel W. Bowles, University of Colorado Cancer Center, Aurora, CO.
Peter R. Chai, Brigham and Women's Hospital, Boston, MA.
Anuja Damani, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Arjun Gupta, University of Minnesota, Minneapolis, MN.
Sigrun Hallmeyer, Advocate Health - MidwestFollow
Ishwaria M. Subbiah, Sarah Cannon Research Institute, Nashville, TN.
Chris Twelves, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Mark S. Wallace, University of California San Diego, La Jolla, CA.
Eric J. Roeland, Oregon Health and Science University, Knight Cancer Institute, Portland, OR.

Recommended Citation

Braun IM, Bohlke K, Abrams DI, et al. Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline. J Clin Oncol. Published online March 13, 2024. doi:10.1200/JCO.23.02596

Affiliations

Advocate Lutheran General Hospital

Abstract

Purpose:To guide clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis and cannabinoids, including synthetic cannabinoids and herbal cannabis derivatives; single, purified cannabinoids; combinations of cannabis ingredients; and full-spectrum cannabis.

Methods:A systematic literature review identified systematic reviews, randomized controlled trials (RCTs), and cohort studies on the efficacy and safety of cannabis and cannabinoids when used by adults with cancer. Outcomes of interest included antineoplastic effects, cancer treatment toxicity, symptoms, and quality of life. PubMed and the Cochrane Library were searched from database inception to January 27, 2023. ASCO convened an Expert Panel to review the evidence and formulate recommendations.

Results:The evidence base consisted of 13 systematic reviews and five additional primary studies (four RCTs and one cohort study). The certainty of evidence for most outcomes was low or very low.

Recommendations:Cannabis and/or cannabinoid access and use by adults with cancer has outpaced the science supporting their clinical use. This guideline provides strategies for open, nonjudgmental communication between clinicians and adults with cancer about the use of cannabis and/or cannabinoids. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. Cannabis and/or cannabinoids may improve refractory, chemotherapy-induced nausea and vomiting when added to guideline-concordant antiemetic regimens. Whether cannabis and/or cannabinoids can improve other supportive care outcomes remains uncertain. This guideline also highlights the critical need for more cannabis and/or cannabinoid research.Additional information is available at www.asco.org/supportive-care-guidelines.

Type

Article

PubMed ID

38478773